Improved Maternal and Children's Health Coverage Act

Summary

Improved Maternal and Children's Health Coverage Act- Amends titles XIX (Medicaid) and XXI (Children's Health Insurance Program) (CHIP) of the Social Security Act (SSA) to mandate: (1) development and use of a uniform, simplified application form for establishing eligibility for Medicaid and CHIP benefits; and (2) coordinated enrollment processes. (Sec. 2) Provides for the expanded availability of funding for administrative costs related to certain outreach and eligibility determinations under Medicaid and CHIP with regard to children and pregnant women. Directs the Secretary of Health and Human Services to establish a procedure with regard to the participation of local and community-based public or nonprofit organizations in outreach and enrollment activities if States do not otherwise obligate the amounts made available under this Act. Sets forth a special rule for certain enrollment and outreach activities providing for use of three percent of CHIP funds at 90 percent Federal match for such activities. Amends SSA title XIX to provide for additional entities (including elementary and secondary schools, child support enforcement agencies, and child care resource and referral agencies) that are qualified to determine Medicaid presumptive eligibility for low-income children. (Sec. 3) Amends SSA title XXI to require, to the extent a State child health plan provides coverage other than through providing benefits under the State's Medicaid plan, a State child health plan to: (1) specify methods to ensure coordination of pediatric care within a family; (2) make the State and its contractors, and not beneficiaries and families, responsible for applying limitations on cost-sharing; (3) impose, at its option, a flat limit (of up to $500) on out-of-pocket expenditures for certain low-income children (as an alternative to the current five percent of family income); and (4) provide a grace period and prior notice before disenrollment for nonpayment of premiums, if the State child health plan requires the payment of a premium and such premium is not paid on a timely notice, as well as an opportunity for a hearing on the matter. Prohibits State child health plan eligibility standards from permitting the use of mandatory waiting periods, unless the Secretary finds that such a period would not be contrary to title XXI. (Sec. 4) Amends SSA title XIX to provide, among other changes, for: (1) automatic reassessment of eligibility for CHIP and Medicaid benefits for children losing Medicaid or CHIP eligibility; (2) optional CHIP coverage of low-income, uninsured pregnant women; ; (3) elimination of the funding offset for exercise of the presumptive eligibility option; (4) automatic enrollment of children born to targeted low-income pregnant women receiving pregnancy-related assistance under such programs; and (5) CHIP and Medicaid program coordination with the Maternal and Child Health Services program under SSA title V.

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Documents

3 official files

• Introduced in Senate (text)

  Introduced in Senate · EN · 28 September 1999

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• Introduced in Senate (PDF)

  Introduced in Senate · EN · 28 September 1999

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• Introduced in Senate

  summary · EN · 28 September 1999

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